Purpose: Medication errors (MEs) are a major factor limiting the effectiveness and safety of pharmacological therapies in critically ill patients. The purpose was to determine if a preventive interventions program (PIP) is associated with a significant reduction on prevalence of patients with MEs in intensive care unit (ICU). Methods: A prospective before-after study was conducted in a random sample of adult patients in a medical-surgical ICU. Between 2 observational phases, a PIP (bundle of interventions to reduce MEs) was implemented by a multidisciplinary team. Direct observation was used to detect MEs at baseline and postintervention. Each medication process, that is, prescription, transcription, dispensing, preparation, and administration, was compared with what the prescriber ordered; if there was a difference, the error was described and categorized. Medication errors were defined according to the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 410 medications for 278 patients were evaluated. A 31.7% decrease on the prevalence of patients with MEs (41.9%-28.6%; P b .05) was seen. Main variations occurred in antiinfectives for systemic use and prescription and administration stage. Conclusions: The implementation of PIP by a multidisciplinary team resulted in a significant reduction on the prevalence of patients with ME at an adult ICU.

Effects of the implementation of a preventive interventions program on the reduction of medication errors in critically

Essa investigacao identificou e analisou o sistema de medicacao de 04 hospitais universitarios, localizados nas cidades de Recife, Ribeirao Preto, Goiânia e Sao Paulo, apos a aprovacao nos Comites de Etica em Pesquisa e da autorizacao da direcao dos hospitais. Os dados foram coletados atraves de entrevista estruturada com um dos profissionais responsaveis pelo sistema de medicacao e observacao nao participante e direta, por uma semana, nos varios sub-sistemas. Os resultados indicaram pontos que necessitam de aperfeicoamentos como utilizacao de abreviacoes, falta de padronizacao de horarios de administracao de medicamentos, falta de informacoes atualizadas e completas do paciente, farmacia nao funcionando 24 horas em um hospital, falta de centro de informacoes de medicamentos e outros. Evidenciou-se no hospital A 66 etapas, no B 58 etapas, no C 70 etapas e no D 80 etapas do sistema de medicacao. Simplificar os processos, diminuindo o numero de etapas, e a chave para a reducao de erros de medicacao.

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Aspectos generales y número de etapas del sistema de medicación en cuatro hospitales brasileños

http://repositorio.uchile.cl/bitstream/handle/2250/129169/Effects%20of%20the%20implementation.pdf;sequence=1

Effects of the implementation of a preventive interventions program on the reduction of medication errors in critically ill adult patients.

1 Executive summary 3 1 Background 7 1.1 Aims and rationale for current review 7 1.2 Definitional and conceptual issues 9 1.3 Research background 10 1.4 Objective 11 2. Methods used in the review 12 2.1 User involvement 12 2.2 Identifying and describing studies 12 2.3 Quality assurance 14 2.4 Data extraction 14 2.5 Quality assessment 14 2.6 Methods for synthesis 15 2.7 Deriving conclusions and implications 16 3. Search results 17 4. Synthesis results 19 4.1 Further details of studies included in the synthesis 19 4.2 Synthesis of evidence 24 4.3 Synthesis: quality assurance results 33 4.4 Summary of the results of the synthesis 33 5. Strengths and limitations 35 6. Conclusions and recommendations 37 7. References 38 Appendices 45 Appendix 1.1: Authorship of this report 45 Appendix 2.1: Search strategy 46 Appendix 3.1: Study details 48 Appendix 4.1: Forest Plots 58 Appendix 4.2: GRADE summary of evidence 67 Appendix 4.3: GRADE evidence profiles 69

/pdf/private-versus-public-strategies-for-health-service-2ve2p5o720.pdf

Private versus public strategies for health service provision for improving health outcomes in resource-limited settings.

A avaliacao da qualidade de servicos hospitalares vem ganhando importância no mundo, sendo impulsionada pela demanda de financiadores, prestadores, profissionais e pacientes. O objetivo deste estudo e revisar a literatura sobre estudos de avaliacao da qualidade hospitalar no Brasil e analisar as principais abordagens, metodologias e indicadores utilizados. Foi aplicada revisao sistematica de artigos cientificos, dissertacoes e teses com analises empiricas sobre o tema, publicados entre 1990 e 2011. Foram identificados 2.169 documentos e incluidos 62 documentos na revisao, que representam 48 estudos distintos. Predominou o uso de fontes de dados secundarias com analise das dimensoes efetividade, adequacao, seguranca e eficiencia, destacando-se a aplicacao da taxa de mortalidade, taxa de adequacao, taxa de eventos adversos e tempo de permanencia. Metodos que controlam diferencas de risco dos pacientes foram majoritariamente aplicados. Busca-se com esta revisao contribuir apontando elementos centrais para o desenvolvimento do tema no pais e para a qualificacao do cuidado prestado.

/pdf/avaliacao-da-qualidade-do-cuidado-hospitalar-no-brasil-uma-3h31929nhp.pdf

Avaliação da qualidade do cuidado hospitalar no Brasil: uma revisão sistemática

https://revistafarmaciahospitalaria.sefh.es/gdcr/index.php/fh/article/download/1016/1016

M.G.G. de Oliveira

Papers

Errores de medicación de dos hospitales de Brasil